J Rhinol.  2022 Jul;29(2):88-95. 10.18787/jr.2021.00399.

Analysis of Lateral Decubitus Position During Sleep in Patients With Obstructive Sleep Apnea Using WatchPAT Device

• Oh J
• Cho Y
• Kim DY

• KMID: 2532010
• DOI: http://doi.org/10.18787/jr.2021.00399

Abstract

Background and Objectives
Measurement of sleep parameters in both supine and non-supine positions is important for the diagnosis of positional obstructive sleep apnea (OSA). However, the influence of right and left lateral decubitus positions (RLDP and LLDP, respectively) on sleep parameters is relatively unknown and has not been well investigated. This study was performed to verify the associations between sleep parameters and lateral decubitus sleep position.
Methods
A retrospective study was performed on 38 patients who were diagnosed with OSA and underwent surgical interventions from January 2014 to December 2016. Preoperative sleep parameters were evaluated with WatchPAT, and patients who slept sufficiently in both RLDP and LLDP to accurately analyze sleep parameters were enrolled in the study. Basic clinical data including body mass index (BMI) and nasal endoscopic findings of patients were assessed.
Results
The difference in peripheral arterial tonometry apnea-hypopnea index (pAHI) and PAT respiratory disturbance index (pRDI) between RLDP and LLDP showed no association with the side of deviated nasal septum. Patients with higher BMI showed higher pRDI in LLDP than RLDP (p=0.038). The difference in sleep position percentage between RLDP and LLDP was negatively correlated with the difference in pRDI (p=0.023).
Conclusion
Higher BMI patients with OSA might benefit more from sleeping in RLDP than LLDP. Patients slept longer in the lateral decubitus position that produced lower pRDI. Not only supine and non-supine positions, but also RLDP and LLDP need to be evaluated in patients with OSA.

Keyword

Obstructive sleep apnea; Body mass index; Polysomnography; Nasal septum

Figure

• 

  Fig. 1 Correlation between the body mass index and the difference in sleep parameters from the RLDP to LLDP. RLDP, right lateral decubitus position; LLDP, left lateral decubitus position; pRDI, peripheral arterial tonometry respiratory disturbance index; RDI (Rt–Lt), difference in pRDI from RLDP to LLDP; ABS RDI, absolute value of the difference in the pRDI between the RLDP and LLDP; pAHI, peripheral arterial tonometry apnea-hypopnea index; AHI (Rt–Lt), difference in pAHI from RLDP to LLDP; ABS AHI, absolute value of the difference in the pAHI between the RLDP and LLDP; % (Rt–Lt), difference in sleep position percentage from RLDP to LLDP. *p<0.05.

• 

  Fig. 2 Correlation between the difference in the sleep position percentage and pRDI from the RLDP to LLDP. RLDP, right lateral decubitus position; LLDP, left lateral decubitus position; pRDI, peripheral arterial tonometry respiratory disturbance index; RDI (Rt–Lt), difference in pRDI from RLDP to LLDP; % (Rt–Lt), difference in sleep position percentage from RLDP to LLDP (p=0.023, R2=0.135).

• 

  Fig. 3 Correlation between the difference in the sleep position percentage and pAHI from the RDLP to LLDP. RLDP, right lateral decubitus position; LLDP, left lateral decubitus position; pAHI, peripheral arterial tonometry apnea-hypopnea index; AHI (Rt–Lt), difference in pAHI from RLDP to LLDP; % (Rt–Lt), difference in sleep position percentage from RLDP to LLDP (p=0.066, R2=0.091).

• 

  Fig. 4 Box plot of association between the side of the DNS and the differences in sleep position, pRDI, and pAHI from the RLDP to LLDP. pRDI, peripheral arterial tonometry respiratory disturbance index; pAHI, peripheral arterial tonometry apnea-hypopnea index; RLDP, right lateral decubitus position; LLDP, left lateral decubitus position; DNS, deviated nasal septum; % (Rt–Lt), difference in sleep position percentage from the RLDP to LLDP; RDI (Rt–Lt), difference in the pRDI from the RLDP to LLDP; AHI (Rt–Lt), difference in pAHI from the RLDP to LLDP.

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